Most Relevant Information
Provider Data
| NPI Number: | 1003685256 |
| Provider Name: | ARIANNA LYNN NICOLAYSEN CLC |
| Entity Type: | Individual |
| Taxonomy Code: | 174N00000X |
| Specialty: | Lactation Consultant, Non-RN |
| License Number: | 356322 |
Most Important Dates
| Enumeration Date: | 12/29/2023 |
| Last Updated: | 12/29/2023 |
Provider Practice Location
4946 GALENA ST
CHUBBUCK
ID
832023060
Practice Location Phone/Fax
| Phone: | 2082434077 |
| Fax: |
Provider Mailing Location
4946 GALENA ST
CHUBBUCK
ID
832023060
Provider Mailing Phone/Fax
| Phone: | 2082434077 |
| Fax: |